Clinical Chemistry 48:10
1703–1714 (2002)
Duration of Detectable Methamphetamine and
Amphetamine Excretion in Urine after Controlled
Oral Administration of Methamphetamine to
Humans
Jonathan M. Oyler,1* Edward J. Cone,2 Robert E. Joseph, Jr.,3 Eric T. Moolchan,1 and
Marilyn A. Huestis1
Background: Confirmation of a workplace drug test
requires urinary methamphetamine (MAMP) and am-
phetamine (AMP) concentrations >500 and 200 ␮g/L,
respectively, but cutoffs at half those values (250/100
␮g/L) have been proposed. We determined the urinary
excretion of MAMP after oral ingestion and examined
the effect of using lower cutoffs on detection of expo-
sure.
Methods: Volunteers (n ⴝ 8) ingested four 10-mg doses
of MAMP 䡠 HCl daily over 7 days, and five of them
ingested four 20-mg doses 4 weeks later. After ingestion,
the volunteers collected all urine specimens for 2 weeks.
After solid-phase extraction, MAMP and AMP were
measured by gas chromatography–positive chemical
ionization mass spectrometry with dual silyl derivatiza-
tion.
Results: MAMP and AMP were generally detected in
the first or second void (0.7–11.3 h) collected after drug
administration, with concentrations of 82–1827 and 12–
180 ␮g/L, respectively. Peak MAMP concentrations
(1871– 6004 ␮g/L) after single doses occurred within
1.5– 60 h. MAMP >500 ␮g/L was first detected in the
first or second void (1–11 h) at 524-1871 ␮g/L. Lowering
the MAMP cutoff to 250 ␮g/L changed the initial detec-
tion time little. AMP >200 ␮g/L was first detected in the
2nd–13th (7–20 h) post-administration voids. At a cutoff
of 100 ␮g/L, AMP was first confirmed in the second to
1 4
Chemistry and Drug Metabolism Section, Intramural Research Program,
National Institute on Drug Abuse, 5500 Nathan Shock Dr., Baltimore, MD
21224.
2
ConeChem Research, LLC, 441 Fairtree Dr., Severna Park, MD 21146.
3
Amgen Inc., One Amgen Center Dr., Thousand Oaks, CA 91320.
*Author for correspondence. Fax 410-550-2971; e-mail joyler@intra.
nida.nih.gov.
Received April 23, 2002; accepted May 24, 2002.
1703
Drug Monitoring and
Toxicology
eighth void (4 –13 h). Reducing the cutoff to 250/100 ␮g/L
extended terminal MAMP detection by up to 24 h,
increased total detection time by up to 34 h, and in-
creased the total number of positive specimens by 48%.
Conclusions: At the lower cutoff, initial detection times
are earlier, detection windows are longer, and confirma-
tion rates are increased. Elimination of the AMP re-
quirement would increase detection rates and allow
earlier detection.
© 2002 American Association for Clinical Chemistry
According to the 1999 Drug Abuse Warning Network
(DAWN) report, d-methamphetamine (MAMP)4 is among
the five most common illicit drugs mentioned in emer-
gency department and medical examiner settings in the
US (1 ). The popularity of illicit methylenedioxymetham-
phetamine, other designer amphetamines, and MAMP as
“club drugs” at dance club “raves” has grown. Most
deaths associated with club drugs involved abuse of
MAMP in combination with heroin/morphine, cocaine,
and/or ethanol. According to the Substance Abuse and
Mental Health Services Administration (SAMHSA) (2 ),
the lifetime rate of MAMP use among 12- to 17-year-olds
also doubled between 1996 and 1997. Worldwide, traffick-
ing of amphetamine-type stimulants increased more than
any other drug class during the 1990s, and seizures
quadrupled (3 ). Abuse of the stimulant MAMP is attrib-
Nonstandard abbreviations: MAMP, d-methamphetamine; SAMHSA,
Substance Abuse and Mental Health Services Administration; AMP, d-am-
phetamine; GC-MS, gas chromatography–mass spectrometry; BSTFA, N,O-
bis(trimethyl)trifluoroacetamide; TMCS, trimethylchlorosilane; MTBSTFA,
N-methyl-N-(tert-butyldimethylsilyl)trifluoroacetamide; TBDMCS, tert-butyl-
dimethylchlorosilane; SPE, solid-phase extraction; PCI, positive chemical ion-
ization; NIDA, National Institute on Drug Abuse; TMS, trimethylsilyl; TBDMS,
tert-butyldimethylsilyl; and LOQ, limits of quantification.
1704 Oyler et al.: Detection Times of MAMP and AMP in Urine
utable to its potent dopaminergic and sympathomimetic
effects, including euphoria, improved cognitive and sen-
sory performance, generalized improvement in mood,
increased physical endurance, and appetite suppression
(4 – 8 ). The drug’s strong reinforcing and addictive poten-
tial contributes to abuse, and tolerance to its psychotropic
effects leads to use of toxic doses (6, 9 –14 ). Negative
sequelae are generally attributable to exaggerated central
nervous system and cardiovascular effects
(4, 6, 8, 9, 11, 15–19 ) and include psychosis, paranoia, hy-
perpyrexia, seizures, stroke, tachycardia, arrhythmias,
pericarditis, myocardial ischemia, hypertension, aortic
and cerebral aneurysm dissection, and myocardial infarc-
tion.
MAMP is excreted primarily in urine, with little biliary
excretion of the parent drug or metabolites (20 ). In normal
urine (pH 6 – 8), 37–54% of a dose is excreted as parent
drug and 4 –7% as d-amphetamine (AMP) (21–24 ). Each
unit increase or decrease in urinary pH produces a
respective 7-h increase or decrease in the MAMP plasma
half-life (21 ). Therefore, the percentage of the dose ex-
creted as parent drug can range from as low as 2% in
alkaline (pH ⱖ8.0) to 76% in acidic urine (pH ⱕ5.0). After
administration of AMP, urinary excretion of AMP is
similarly affected by urinary pH (1% and 74% excretion in
alkaline and acidic urine, respectively) (25 ). It has also
been reported that the renal clearance of MAMP exceeds
that of the average renal filtration rate, suggesting the
involvement of an active transport mechanism in the
excretion of MAMP (23 ).
Current SAMHSA requirements for a positive work-
place urine test include an amphetamines screen ⱖ1000
␮g/L (or ng/mL) confirmed by a MAMP concentration
ⱖ500 ␮g/L and an AMP concentration ⱖ200 ␮g/L (500/
200 cutoff) by gas chromatographic–mass spectometric
(GC-MS) analysis (26 ). AMP requirements were instituted
because of the potential for false-positive analytical re-
sults with specimens containing other sympathomimetic
amines (27 ). SAMHSA has recently proposed new work-
place screening cutoff concentrations of 500 ␮g/L and
confirmation cutoffs of 250 and 100 ␮g/L for MAMP and
AMP, respectively (250/100 cutoff) (28 ).
The object of this study was to characterize the urinary
excretion of MAMP and its major active metabolite, AMP,
in humans after controlled oral administration. Urine
concentration data were evaluated to determine detection
windows and confirmation rates based on current and
proposed confirmation cutoffs and cutoffs based on
MAMP requirements alone.
Materials and Methods
chemicals and reagents
Chemicals were obtained from the following sources:
MAMP, AMP, d,l-[2H11]MAMP, and d,l-[2H10]AMP were
from Radian (now Cerilliant); N,O-bis(trimethyl)trifluoro-
acetamide (BSTFA) with 1% trimethylchlorosilane
(TMCS), N-methyl-N-(tert-butyldimethylsilyl)trifluoro-
acetamide (MTBSTFA) with 1% tert-butyldimethylchlo-
rosilane (TBDMCS) were from Pierce Chemical. Solid-
phase extraction (SPE) columns (Clean Screen DAU; 200
mg of packing; 10-mL columns) were obtained from
United Chemical Technologies. Methanol, methylene
chloride, 2-propanol, and acetonitrile were HPLC-grade
chemicals. All other chemicals were reagent grade.
instrumentation
Qualitative and quantitative analyses were performed on
a Hewlett-Packard 6890 gas chromatograph interfaced
with a Hewlett-Packard 5973 mass selective detector. A
split-splitless capillary inlet system operated in the split-
less mode and a HP-1 [12 m ⫻ 0.2 mm (i.d.); 0.33-␮m film
thickness] or Phenomenex ZB-1 [15 m ⫻ 0.25 mm (i.d.);
0.10-␮m film thickness] dimethylpolysiloxane fused-silica
capillary column were used for chromatographic isolation
of analytes. The single quadrupole mass spectrometer was
operated in positive chemical ionization (PCI) mode with
methane as reactant gas as described previously (29 ).
human subjects
This study was conducted at the Intramural Research
Program, National Institute on Drug Abuse (NIDA), in
Baltimore, MD as part of a broader study of the clinical
pharmacokinetics and pharmacodynamics of MAMP after
oral administration. The NIDA Institutional Review
Board approved the protocol. Participants were healthy
volunteers with a history of stimulant and opioid use.
Participants were evaluated medically and psychologi-
cally before admission to the clinical ward to establish
their health. Volunteers provided informed consent and
resided on a closed research unit for ⬃10 weeks. Their
vital signs were monitored daily, and routine blood
testing (CHEM Profile 2) was performed on alternate
weeks for medical evaluation throughout the study. Par-
ticipants were not physically dependent on illicit drugs.
During the study, periodic urine specimens were tested to
ensure that there was no self-administration of drugs.
study protocol
The first 2 weeks of the study served as a clearance phase
for previously self-administered drugs. Morning urine
specimens were collected during this time. Drug admin-
istrations occurred in weeks 3 and 7. In week 3 (low-dose
week), participants (n ⫽ 8) received four daily oral
administrations of MAMP 䡠 HCl (Desoxyn® Gradumet®;
10 mg) at 1030 in the morning. As part of the pharmaco-
dynamic study, participants were administered placebo
MAMP capsules in week 6. Lactose was substituted for
sustained-release MAMP to contrast physiologic and sub-
jective responses after active and placebo MAMP. During
week 7 (high-dose week), participants (n ⫽ 5) received
four 20-mg oral administrations of MAMP 䡠 HCl. Partici-
pants were scheduled to receive four consecutive daily
administrations of the sustained-release formulation, the
only form of MAMP available for therapeutic administra-
 Clinical Chemistry 48, No. 10, 2002
tion at the time of this study. Abbott Laboratories discon-
tinued production of Desoxyn Gradumet in 1999; the
Desoxyn formulation is currently available. If physiologic
measures (i.e., heart rate, blood pressure, and tempera-
ture) did not meet NIDA Intramural Research Program
medical dosing criteria on the scheduled administration
day, drug administration was sometimes delayed by 24 h.
However, participants always received four doses once
daily within 7 days. We therefore have grouped the data
into three categories: single, consecutive, and nonconsec-
utive administration regimens (see section on data anal-
ysis). The total base equivalent amounts of MAMP admin-
istered in the low- and high-dose regimens were 32.2 and
64.3 mg, respectively. Three participants did not receive
the high-dose regimen because of personal choice, medi-
cal disqualification, or behavioral misconduct. All drug
administrations were conducted under subject-blind con-
ditions. Urine specimens were collected ad libitum after
initiation of the dosing regimen. Specimens were collected
in polypropylene bottles, and void volumes were re-
corded. Approximately 15 mL was aliquoted into
polypropylene cryotubes and stored at ⫺20 °C until anal-
ysis.
calibrators and controls
Calibrators and controls were prepared in urine that was
collected from laboratory volunteers and was demon-
strated to be negative for MAMP and AMP by GC-MS
analysis before use in the preparation of calibrators and
controls. Two dynamic linear ranges were established for
the assay. Quantitative analysis was performed by use of
split curves at concentration ranges of 2.5–100 and 100-
1000 ␮g/L. Specimen samples were analyzed using the
curve with the appropriate dynamic range. Specimens
with concentrations ⬎1000 ␮g/L were diluted with 0.5
mol/L sodium acetate buffer (pH 4.0) and reanalyzed to
bring them within the dynamic range of the assay.
[2H11]MAMP and [2H10]AMP were added as internal
standards to each sample (100 ng in 0.1 mL of H2O).
MAMP and AMP curves were prepared in duplicate at
drug concentrations ranging from 1.25 to 1000 ␮g/L.
Calibrators and controls were prepared from different
commercially available drug lots and by different ana-
lysts. Duplicate controls at 10, 100, and 250 ␮g/L were
prepared and analyzed at the beginning and end of each
sample batch. Linear regression analysis of control sam-
ples containing 10 and 100 ng of drug were performed
using the 2.5–100 ␮g/L curves, and 250 ng controls were
analyzed using the 100-1000 ␮g/L curves. Quantitative
results for all controls across sample batches were within
20% of their target concentrations.
mamp and amp isolation from urine
Calibrators, controls, and specimens were processed by
SPE according to a previously published method (30 ).
Briefly, 1 mL of urine was aliquoted, 100 ng of each
internal standard was added, and samples were adjusted
1705
to acidic pH with 0.5 mol/L sodium acetate buffer (pH
4.0). Analytes were isolated on preconditioned SPE col-
umns and eluted with methylene chloride–2-propanol–
ammonium hydroxide (80:20:2 by volume). After SPE,
AMP analogs were stabilized by addition of 20 ␮L of
MTBSTFA ⫹ 1% TBDMCS to each tube. Samples were
evaporated under nitrogen in a water bath at 40 °C until
dry. A 500-␮L aliquot of acetonitrile was added, and tubes
were vortex-mixed to recover drug from centrifuge tube
walls. After evaporation to dryness, 20 ␮L of acetonitrile
was added, tubes were vortex-mixed and centrifuged,
and samples were transferred to autosampler vials. A
20-␮L aliquot of MTBSTFA ⫹ 1% TBDMCS was added to
each vial. Vials were loosely capped and placed in a heat
block at 80 °C for 15–20 min. A 20-␮L aliquot of BSTFA ⫹
1% TMCS was added, vials were crimp-capped, and
samples were heated at 80 °C for 45 min. One microliter
was injected for analysis under splitless GC/PCI-MS
conditions.
This dual derivatization scheme was originally devel-
oped as a method for the analysis of multiple basic
drug classes. Addition of MTBSTFA to samples after SPE
and before evaporation was found to greatly reduce
volatility losses of the amphetamines. tert-Butyldimethyl-
silyl (TBDMS) derivatization of the primary amine of AMP
proceeds readily. However, formation of the TBDMS
derivative of MAMP, a secondary amine, is sterically
hindered, similar to the normetabolites of cocaine and the
opiates (31 ). Consequently, BSTFA was used in a second
derivatization step to produce the trimethylsilyl (TMS)
derivative of MAMP. Under the derivatization conditions
described, there was selective formation of the TMS
derivative of MAMP and the TBDMS derivative of AMP.
Time course experiments demonstrated that ⬎95% of
MAMP was converted to the TMS derivative and ⬎95% of
AMP was converted to the TBDMS derivative.
method specificity and sensitivity
Samples containing single analytes in acetonitrile were
derivatized and analyzed by GC/PCI-MS in full scan
mode for spectral characterization. The ions chosen as
quantitative ions for MAMP, [2H11]MAMP, AMP, and
[2H10]AMP were m/z 130, 136, 158 and 162, respectively.
Confirming ions, retention order, and derivatives are
listed in Table 1. Urine specimen analyte concentrations
were determined in selected ion monitoring mode. Urine
controls to which MAMP and AMP had been added were
Table 1. MAMP and AMP derivatives, elution order, and
target and confirming ions.
Elution Target ion, Confirming ions,
Analyte Derivative order m/z m/z
MAMP-d11 TMS 1 136 217, 231, 261
MAMP TMS 2 130 206, 220, 250
AMP-d10 TBDMS 3 162 244, 260, 202
AMP TBDMS 4 158 234, 250, 192
1706 Oyler et al.: Detection Times of MAMP and AMP in Urine
serially diluted (0.5–10 ␮g/L) and analyzed in quadrupli-
cate to determine the limits of quantification (LOQ). The
following criteria were used to determine LOQ: (a) quan-
tifying ion signal-to-noise ratio (determined by peak
height) was ⬎3:1; (b) 75% of control replicates (n ⫽ 4)
calculated within ⫾25% of the target concentration; and
(c) confirming ion ratios were within 20% of those ob-
served for a within-run 10 ␮g/L (167 pg on column)
calibrator. LOQ for MAMP and AMP were 2.5 ␮g/L (42
pg on column). Sensitivity and specificity criteria were
met by both the HP-1 and Phenomenex ZB-1 dimethyl-
polysiloxane GC capillary columns.
data analysis
Data were analyzed using method LOQ, the 500/200 and
250/100 cutoffs, and cutoffs requiring only 500 or 250
␮g/L MAMP. Initial and final detection times, peak
concentrations, percentage detection rates, and AMP-
MAMP percentage ratios were determined. The initial
detection time after first administration and final detec-
tion time after last administration were defined as the first
and last specimens positive at or above respective cutoffs.
The percentage detection rate was determined by divid-
ing the number of positive specimens collected over a
time period by the total number of specimens collected
over the same time period and multiplying by 100. Mean
detection rates were determined by averaging rates from
all participants over a collection period. Total detection
rates were also determined by dividing the sum of all
positive specimens from all participants by the total
number of specimens collected over a collection period.
AMP-MAMP concentration ratios were multiplied by 100
to determine percentage ratios. Individual, mean, and
total 12-h detection rates were determined after single
doses. Ranges and means for final detection times and
void number, total urine specimens collected from first
drug administration to last positive specimen, total posi-
tive specimens from initial dosing to last positive speci-
men, and total detection rates across participants and
doses were also determined.
Specimen volumes were multiplied by the respective
MAMP and AMP concentrations to determine the total
amount of MAMP and AMP excreted per void. These
products were then summed to determine the total base
amounts of MAMP and AMP excreted after the low- or
high-dose regimens. The percentage of MAMP eliminated
in urine after each administration regimen was deter-
mined by dividing the total amount of MAMP excreted by
the total amount of base drug administered in the low-
and high-dose regimens (32.2 and 64.4 mg, respectively)
and multiplying the quotient by 100 (percentage of dose
excreted as MAMP). The percentage of AMP eliminated
in urine was determined by dividing the moles of AMP
excreted by the total moles of MAMP administered and
multiplying the quotient by 100 (percent molar dose
excreted as AMP).
Because of postponements that occurred in daily drug
administration schedules for several participants, the data
were categorized by regimen into three subsets: four
consecutive administrations (n ⫽ 8), four nonconsecutive
administrations within 7 days (n ⫽ 5), and single admin-
istrations (n ⫽ 5). All single-administration data were
collected after low-dose administrations. Administrations
were considered single if specimens from five consecutive
urine voids collected immediately before the next dosing
were negative for both MAMP and AMP at their respec-
tive LOQ. Nonconsecutive administrations had random 2-
to 4-day intervals between administrations.
Results
excretion pattern, loq detection times and
rates, and amp-mamp ratios
With the 2.5 ␮g/L LOQ, initial detection of MAMP
generally occurred in the first urine void. Only two
participants had initial detection of MAMP later than the
first void, and they were also the only participants from
whom specimens were collected ⬍0.5 h after drug admin-
istration. After the first drug administration of each
regimen, measurable concentrations of both MAMP and
AMP initially occurred in the first to fourth void collected,
and no dose– detection time or regimen– detection time
relationship was observed (Tables 2 and 3).
MAMP was initially measured at concentrations rang-
ing from 82 to 1827 ␮g/L. Peak concentrations after initial
low- and high-dose drug administration ranged from
1871 to 6004 ␮g/L and occurred in the 2nd to 15th void
collected at 1.5– 43.7 h after dosing. Peak MAMP concen-
trations after single-administration regimens ranged from
2310 to 14 660 (mean ⫾ SD, 4720 ⫾ 2302) ␮g/L, respec-
tively. Peak MAMP concentration ranges after consecu-
tive low- and high-dose regimens were 5317–7003 (5338 ⫾
1652) ␮g/L and 5092–13 824 (9466 ⫾ 3639) ␮g/L, respec-
tively. Peak MAMP concentrations after nonconsecutive
low-dose regimens were 3598 –10 905 (6936 ⫾ 3005) ␮g/L,
and the peak MAMP concentration after one nonconsec-
utive high-dose regimen was 18 468 ␮g/L.
AMP was initially detected in the first to fourth urine
specimen collected after single administrations of low and
high doses at much lower concentrations (12–180 ␮g/L).
Peak AMP concentrations after single-administration reg-
imens occurred in the 2nd to 29th void collected at
12.0 –58.3 h and ranged from 264 to 660 ␮g/L. Peak AMP
concentrations after consecutive low- and high-dose reg-
imens were 422-2872 and 1195– 4016 ␮g/L, respectively.
Peak AMP concentrations after nonconsecutive low-dose
regimens were 370-1649 ␮g/L, and the peak AMP con-
centration after one nonconsecutive high-dose regimen
was 5992 ␮g/L.
After consecutive daily administrations, successive
trough MAMP and AMP concentrations increased, indi-
cating accumulation. Fig. 1 illustrates the within-regimen
variability in MAMP and AMP excretion over the urinary
elimination time course for volunteer S after single, con-
secutive, and nonconsecutive drug administrations.
 Clinical Chemistry 48, No. 10, 2002 1707

Table 2. Initial MAMP detection times and initial detection voids at different cutoff concentrations after the first 10-mg
MAMP 䡠 HCl administration.
Initial detection time, h Initial detection void

Cutoff a
Regimen b
Volunteers, n Range Mean ⴞ SD Range Mean
LOQ Single 5 0.7–4.2 2.8 ⫾ 1.6 1–2 1.4
Nonconsecutive 4 1.4–11.3 4.6 ⫾ 4.5 1–2 1.5
Consecutive 4 4.0–9.1 5.6 ⫾ 2.3 1–4 1.8
Across regimensc 13 0.7–11.3 4.2 1–4 1.6
250 Single 5 0.5–4.2 2.0 ⫾ 1.4 1–2 1.2
Nonconsecutive 4 1.4–11.3 4.9 ⫾ 4.4 1–2 1.8
Consecutive 4 3.2–9.1 5.2 ⫾ 2.6 1–3 1.5
Across regimensc 13 0.5–11.3 3.9 1–3 1.5
250/100 Single 5 0.5–4.3 3.0 ⫾ 1.7 1–4 1.8
Nonconsecutive 4 4.3–17.2 10.3 ⫾ 5.4 1–9 4.5
Consecutive 4 6.6–10.1 8.5 ⫾ 1.9 2–5 3.3
Across regimensc 13 0.5–17.2 6.9 1–9 3.1
500 Single 5 1.4–4.3 3.0 ⫾ 1.3 1–2 1.8
Nonconsecutive 4 1.4–11.3 4.9 ⫾ 4.4 1–2 1.8
Consecutive 4 3.2–9.1 6.2 ⫾ 2.8 1–3 1.8
Across regimensc 13 1.4–11.3 4.6 1–4 1.8
500/200 Single 5 4.2–12.0 8.3 ⫾ 3.3 1–7 4.8
Nonconsecutive 4 9.3–17.2 15.0 ⫾ 4.1 2–9 6.5
Consecutive 4 11.4–19.6 12.7 ⫾ 5.2 3–8 4.5
Across regimensc 13 4.2–19.6 11.7 1–9 5.2
a
LOQ, concentrations of MAMP and AMP at 2.5 ␮g/L; 250, 250 ␮g/L MAMP; 250/100, 250 ␮g/L MAMP and 100 ␮g/L AMP; 500, 500 ␮g/L MAMP; 500/200,
500 ␮g/L MAMP and 200 ␮g/L AMP.
b
Consecutive, four consecutive daily administrations; Nonconsecutive, four nonconsecutive daily administrations within 7 days; Single, single administration
preceded by five or more specimens negative for MAMP and AMP at their respective LOQ.
c
Mean values are weighted.

The total amount of MAMP excreted over the LOQ
detection window ranged from 8.9 to 29.5 mg and 16.1 to
27.2 mg, equivalent to 25–92% and 25– 43% of the low and
high doses, respectively. The total amount of AMP ex-
creted ranged from 1.2 to 4.8 and 3.2 to 8.6 mg, represent-
ing 5–20% and 7–18% of the molar MAMP dose for the
low and high doses, respectively.
Large intersubject variability in AMP-MAMP ratios
were observed, whereas intrasubject ratios after consecu-
tive administration consistently increased over time. Ini-

Table 3. Initial MAMP detection times and initial detection voids at different cutoff concentrations after the first 20-mg
MAMP 䡠 HCl administration.
Initial detection time, h Initial detection void

Cutoff Regimen Volunteers, n Range Mean ⴞ SD Range Mean

LOQ Nonconsecutive 1 6.1 6.1 1 1
Consecutive 4 1.2–8.8 4.6 ⫾ 3.2 1–4 1.9
Across regimensa 5 1.2–8.8 4.9 1–4 1.7
250 Nonconsecutive 1 3.3 3.3 1 1
Consecutive 4 1.2–8.8 4.0 ⫾ 3.3 1–4 1.8
Across regimensa 5 1.2–8.8 3.9 1–4 1.6
250/100 Nonconsecutive 1 3.3 3.3 1 1
Consecutive 4 8.8–13.1 10.5 ⫾ 1.8 1–12 5
Across regimensa 5 3.3–13.1 9.1 1–12 4.2
500 Nonconsecutive 1 3.3 3.3 1 1
Consecutive 4 1.2–8.8 4.6 ⫾ 3.2 1–4 2.0
Across regimensa 5 1.2–8.8 4.3 1–4 1.8
500/200 Nonconsecutive 1 7.9 7.9 2 2
Consecutive 4 12.0–19.6 15.7 ⫾ 3.8 2–13 7.5
Across regimensa 5 7.9–19.6 14.1 2–13 6.4
a
Mean values are weighted.
1708 Oyler et al.: Detection Times of MAMP and AMP in Urine
Fig. 1. Urinary excretion profiles for volunteer S after single (a) and four
nonconsecutive daily oral administrations of 10 mg (b) or four consec-
utive daily oral administrations of 20 mg (c) of sustained-release
MAMP 䡠 HCl.
Arrows indicate MAMP 䡠 HCl administration times.
tial AMP-MAMP ratios ranged from 1% to 18%. AMP-
MAMP ratios increased throughout the elimination time
course after a single dose. With consecutive dosing, a
sharp decrease in AMP-MAMP ratios occurred immedi-
ately after each successive MAMP dose, followed by a
return to the pattern of gradual increase observed after
single dosing. In urine specimens containing peak MAMP
concentrations, AMP-MAMP ratios had increased to
7– 42%, and in the last urine specimen positive for both
analytes, AMP-MAMP ratios were 25–260%. Fig. 2 illus-
trates the increase in AMP-MAMP ratios after a single
dose and the immediate decrease observed after each
successive dose in volunteer BB. This volunteer was the
only participant to receive consecutive administrations of
the low and high doses, but these patterns were consistent
across participants.
Individual urinary 12-h detection rates after the first
administration were 67–100% (mean ⫾ SD, 91.2% ⫾
10.0%) after low-dose regimens and 63–100% (87.6% ⫾
17.5%) after high-dose regimens (Tables 4 and 5). A
Fig. 2. AMP-MAMP ratios for volunteer BB after four consecutive
administrations of 10 (top) or 20 mg (bottom) of sustained-release
MAMP 䡠 HCl.
correlation between regimen and detection rate was not
observed. Of the 100 specimens collected within 12 h of
initial MAMP administration, 87 were positive, for a total
12-h detection rate of 87%. Lack of AMP detection was
responsible for most negative results early in the excretion
of MAMP. With the MAMP and AMP LOQ, no significant
differences were observed in final detection times (range,
46 –169 h) between doses or after single, consecutive, or
nonconsecutive regimens (Tables 6 and 7). With the 2.5
␮g/L cutoffs (LOQs) for MAMP and AMP, the mean final
detection time from the last drug administration was
110.7 h, and the total detection rate across doses and
regimens was 94% (Table 8).
detection times based on 500/200 ␮g/L cutoff
concentrations
Initial detection voids and times after the first low and
high MAMP administration are listed in Tables 2 and 3.
Across doses and regimens with a 500/200 cutoff, MAMP
 Clinical Chemistry 48, No. 10, 2002 1709

Table 4. Individual, mean, and total 12-h detection rates after the first administration of 10 mg of MAMP 䡠 HCl.
Specimens collected 12-h detection rate, %
after initial drug
Volunteer Regimen administration, n LOQ 250 cutoff 250/100 cutoff 500 cutoff 500/200 cutoff
S Single 8 88 88 25 88 25
S Single 7 86 86 43 72 28
Y Single 2 100 100 100 100 50
Z Single 7 100 100 14 86 14
AA Single 7 86 86 14 86 0
Mean ⫾ SD Single 6.2 92.0 ⫾ 7.3 92.0 ⫾ 7.3 39.2 ⫾ 36.0 86.4 ⫾ 9.9 23.4 ⫾ 18.5
S Nonconsecutive 8 88 88 25 88 25
Y Nonconsecutive 1 100 100 100 100 0
Z Nonconsecutive 6 83 83 17 83 0
AA Nonconsecutive 8 88 75 0 63 0
Mean ⫾ SD Nonconsecutive 5.8 89.8 ⫾ 7.2 86.5 ⫾ 10.5 35.5 ⫾ 44.2 83.5 ⫾ 15.4 6.3 ⫾ 12.5
V Consecutive 4 100 100 50 75 25
W Consecutive 2 100 100 100 100 50
X Consecutive 4 100 100 50 100 50
BB Consecutive 3 67 67 0 67 0
Mean ⫾ SD Consecutive 3.3 92.8 ⫾ 16.5 92.8 ⫾ 16.5 50.0 ⫾ 40.8 85.5 ⫾ 17.1 31.25 ⫾ 23.9
Meana Across regimens 5.1 91.2 ⫾ 10.0 90.2 ⫾ 11.0 41.4 ⫾ 37.1 85.2 ⫾ 12.9 20.5 ⫾ 20.1
Total Across regimens 67 89.6 86.6 26.9 82.1 19.4
a
Mean values are weighted.

and AMP were initially detected in specimens 1–13
(mean, 5.6) collected 4.2–19.6 h (mean, 12.4 ⫾ 4.2 h) post
drug administration. MAMP and AMP concentrations
were 1574 – 6004 (3344 ⫾ 1304) and 219-1556 (380 ⫾ 304)
␮g/L, respectively. Initial AMP-MAMP ratios ranged
from 7% to 26%. There were no significant differences
observed in final detection times from last drug adminis-
tration across regimens or doses (Tables 6 and 7). The time
to last positive from the last drug administration was
22– 66 (42.7 ⫾ 22.8) h, 27–92 (53.3 ⫾ 20.6) h, and 46 –70
(58.5 ⫾ 9.8) h after single, consecutive, and nonconsecu-
tive administrations, respectively. Although individual
total detection rates varied substantially, as evidenced by
the data shown for single nonconsecutive administration
of the high dose (89%; Table 7), across all participants and
doses (Tables 6 and 7), the 500/200 total detection rate
after consecutive administrations (59%) was higher than
that after nonconsecutive (39%) or single regimens (39%).
Individual 12-h detection rates (Tables 4 and 5) ranged
from 0% to 67% (20.2% ⫾ 23.8%). Sixteen of 100 total
specimens collected from all participants within 12 h of
initial drug administration were positive, for a total 12-h
detection rate of 16%. Of the 591 specimens collected from
initial drug administration to last positive across partici-
pants, doses, and regimens, 292 were confirmed positive
by the 500/200 cutoff, for a total detection rate of 49%
(Table 8). Detection rate also appeared to be correlated
with micturition interval. Generally, detection rate in-
creased with longer micturition intervals.
The initial detection void and time means and ranges
after low and high doses are listed by regimen in Tables 2
and 3, with elimination of the 200 ␮g/L AMP require-
ment. Individual initial detection voids and times also
were determined across regimens and doses when the 200

Table 5. Individual, mean, and total 12-h detection rates after the first administration of 20 mg of MAMP 䡠 HCl.
12-h detection rate, %

Specimens collected
after initial drug
Volunteer Regimen administration, n LOQ 250 cutoff 250/100 cutoff 500 cutoff 500/200 cutoff
S Consecutive 9 100 100 22 78 0
Y Consecutive 1 100 100 100 100 0
AA Consecutive 12 75 67 8 58 0
BB Consecutive 8 63 100 25 75 12
Mean ⫾ SD Consecutive 7.5 84.5 ⫾ 18.6 91.8 ⫾ 16.5 38.8 ⫾ 41.5 77.8 ⫾ 17.3 3.0 ⫾ 6.0
W Nonconsecutive 3 100 100 100 100 67
Meana Across regimens 5.1 87.6 ⫾ 17.5 93.4 ⫾ 14.8 51.0 ⫾ 45.2 82.2 ⫾ 17.9 15.8 ⫾ 29.1
Total Across regimens 33 81.8 87.9 27.3 72.7 9.1
a
Mean values are weighted.
1710 Oyler et al.: Detection Times of MAMP and AMP in Urine

Table 6. Final detection times and total detection rates after administration of 10 mg of MAMP 䡠 HCl.
Specimens from initial
Final detection time from last administration to last
administration, h positive
Total detection
Cutoff Regimen Volunteers, n Range Mean ⴞ SD Total Positive rate, %
LOQ Single 5 46–144 87.2 ⫾ 51.0 138a 125a 91a
Nonconsecutive 4 71–169 123.0 ⫾ 49.3 247 232 94
Consecutive 4 102–142 125.7 ⫾ 19.2 277 253 91
Across regimens 13 46–169 110.2b 524 485 93
250 Single 5 31–87 55.6 ⫾ 27.9 88a 68a 77a
Nonconsecutive 4 59–71 65.8 ⫾ 5.9 254 182 72
Consecutive 4 44–73 58.2 ⫾ 14.2 171 160 93
Across regimens 13 31–87 59.5b 425 342 80
250/100 Single 5 25–77 51.6 ⫾ 26.3 83a 51a 61a
Nonconsecutive 4 34–71 55.3 ⫾ 15.6 245 123 50
Consecutive 4 44–73 58.2 ⫾ 14.2 169 137 81
Across regimens 13 25–77 54.8b 414 260 63
500 Single 5 25–77 48.4 ⫾ 23.8 80a 54a 68a
Nonconsecutive 4 34–59 52.1 ⫾ 12.3 242 142 59
Consecutive 4 31–55 43.7 ⫾ 10.4 158 138 87
Across regimens 13 25–77 48.1b 400 280 70
500/200 Single 5 22–66 42.7 ⫾ 22.8 72a 28a 39a
Nonconsecutive 4 46–65 54.2 ⫾ 9.5 236 77 33
Consecutive 4 27–55 40.4 ⫾ 13.5 152 87 57
Across regimens 13 22–66 42.7b 391 164 42
a
Contributes to total after nonconsecutive dosing regimen.
b
Mean values are weighted.

␮g/L AMP requirement was eliminated (data not shown)
and led to earlier detection of MAMP exposure [0 –17.2
(7.7 ⫾ 4.8) h or 0 –10 (3.8) voids]. Tables 6 (10-mg dose)
and 7 (20-mg dose) list the final detection times from the
last dose by regimen. Across doses, final detection times
were 25–77 (48.4 ⫾ 23.8) h, 31–92 (55.0 ⫾ 18.7) h, and
34 –70 (61.2 ⫾ 6.0) h after single, consecutive, and noncon-
secutive administrations, respectively. Individual 12-h
detection rates across doses (Tables 4 and 5) were 58 –
100% (84.0% ⫾ 14.0%). With elimination of the 200 ␮g/L
AMP requirement, the total 12-h detection rate across
doses increased from 16% to 79%. In addition, the total
number of positive specimens collected from initial drug
administration to last positive across doses and regimens

Table 7. Final detection times and total detection rates after administration of 20 mg of MAMP 䡠 HCl.
Final detection time from Specimens from initial
last dose, h dosing to last positive, n
Volunteers, Total detection
Cutoff Regimen n Range Mean ⴞ SD Total Positive rate, %
LOQ Nonconsecutive 1 169 169 42 40 95
Consecutive 4 94–137 99.5 ⫾ 27.3 209 200 96
Across regimens 94–169 113.4a 251 240 96
250 Nonconsecutive 1 94.5 94.5 31 29 94
Consecutive 4 56–96 77.3 ⫾ 18.8 192 165 86
Across regimens 56–96 80.7a 223 194 87
250/100 Nonconsecutive 1 94.5 94.5 31 29 94
Consecutive 4 56–96 77.3 ⫾ 18.8 186 142 76
Across regimens 5 56–96 80.7a 217 171 79
500 Nonconsecutive 1 70 70 28 25 89
Consecutive 4 46–92 66.2 ⫾ 19.2 172 143 83
Across regimens 5 46–92 67.0a 200 168 84
500/200 Nonconsecutive 1 70 70 28 25 89
Consecutive 4 46–92 66.2 ⫾ 19.2 172 103 60
Across regimens 5 46–92 67.0a 200 128 64
a
Mean values are weighted.
 Clinical Chemistry 48, No. 10, 2002 1711

Discussion
Table 8. Final detection times and total detection rates
MAMP is abused for its euphoric and performance effects.
across MAMP doses and administration regimens.
Reports indicate that truck drivers, construction workers,
Final detection time Specimens from initial
from last dose, h dosing to last positive, n Total young professionals, and students commonly self-admin-
detection ister single doses of MAMP to improve performance and
a
Cutoff Range Mean Total Positive rate, %
to prevent or reverse somnolence (32 ). However, even
LOQ 46–169 110.7 775 725 94
low single doses (0.3 mg/kg) of MAMP can lead to
250 31–96 65.2 648 536 83
250/100 25–96 64.1 631 431 68
physiologic and behavioral changes (33 ). Rapid develop-
500 25–92 54.8 600 448 75 ment of tolerance to the “feel good” and “high” drug
500/200 22–92 51.7 591 292 49 effects after subchronic administration of low to moderate
a
Mean values are weighted.
doses has been demonstrated in humans (11, 22, 34 ) and
nonhuman primates (12, 13 ). Identification of both habit-
ual and occasional abusers is an important component of
medical, workplace, criminal justice, military, and foren-
increased from 292 to 448, and the total detection rate also
sic drug testing programs. Therefore, it is important to
increased, from 49% to 75% (Table 8), without the AMP
describe the urinary excretion of MAMP and AMP after
requirement.
controlled administration of single and multiple doses of
MAMP and to evaluate the effects of cutoff changes on
detection times based on 250/100 cutoff detection times and rates after these regimens. Results
concentrations from these studies should help determine interindividual
Initial detection based on the 250/100 cutoff (Tables 2 and differences in metabolism and excretion of MAMP. Com-
3) occurred in the 1st to 12th (mean⫽3.7) post-drug pilation of MAMP excretion data after controlled admin-
administration specimens, collected at 1–17 (7.5 ⫾ 3.0) h. istration will also provide a scientific database for im-
Reducing the cutoff from 500/200 to 250/100 shifted proved interpretation of urine drug testing and will aid in
initial confirmation to the left by up to five voids or 11 h. the development of drug testing policy.
Lowering the AMP cutoff requirement was responsible MAMP is abused via the smoked, intravenous, and
for earlier MAMP detection in all cases. Individual 12-h oral routes of administration. The hydrochloride salt is
detection rates (Tables 4 and 5) ranged from 0% to 100% highly water soluble, and unlike cocaine, which must be
(44.1% ⫾ 38.4%); the total 12-h detection rate was 28%. converted from its salt to base form before smoking,
Final detection time from last drug administration was MAMP 䡠 HCl can be smoked, injected, or administered
25–77 (mean, 51.6) h, 44 –96 (67.8) h, and 34 –95 (70.5) h orally. AMP is a primary metabolite of MAMP in humans
after single, consecutive, and nonconsecutive administra- (35 ) as well as a commonly abused stimulant. It is also a
tions, respectively (Tables 6 and 7). Low MAMP and AMP pyrolytic product formed when MAMP is smoked (36 –
concentrations were equally likely to limit final detection. 38 ). MAMP 䡠 HCl is more prone to pyrolytic N-demeth-
In 9 of 18 sessions, the specimen collected immediately ylation than is MAMP base because of its protonated
after the last positive specimen had a MAMP concentra- nitrogen and nucleophilic chlorine (36 ).
tion ⬍250 ␮g/L with an AMP concentration ⬎100 ␮g/L. This study was part of a larger study on the pharma-
When we compared the 500/200 and the 250/100 cutoffs, cokinetics and disposition of MAMP in various biological
the number of positive specimens from initial drug ad- matrices. Because MAMP and AMP concentrations in
ministration to last positive specimen for eight partici- many of these matrices were expected to be low, we used
pants across doses and regimens increased from 292 to PCI-MS to achieve the required sensitivities. However,
431 and the total detection rate increased from 49% to 68% the impact of confirmation cutoffs on the interpretation of
(Table 8). data would be the same with any mass spectrometric
Elimination of the 100 ␮g/L AMP cutoff requirement method for which adequate sensitivity and specificity
(250 ␮g/L MAMP cutoff) shifted initial MAMP detection have been demonstrated.
by up to seven voids (Tables 2 and 3), occurring in voids In a report by Wu et al. (39 ), 83 urine specimens that
1– 4 (mean, 1.5), collected 0.5–11.3 (mean ⫾ SD, 3.9 ⫾ 2.7) had screened positive for MAMP by immunoassay were
h after drug administration. In three instances, final analyzed by GC/ion-trap MS to determine the effect of
detection time also increased by 6 –10 h. The mean indi- the 200 ␮g/L AMP cutoff requirement on MAMP confir-
vidual 12-h detection rate was 91% (range, 67–100%); the mation testing. The authors did not define the ionization
total 12-h detection rate was 88%. When we compared the technique used. The limits of detection and quantification
500/200 and 250 cutoffs across doses and participants, the of their assay were 50 and 100 ␮g/L, respectively. They
total number of positive specimens collected from initial found that 12 specimens contained AMP alone and 52 met
drug administration to last positive increased from 292 to the 500/200 cutoff requirements. However, two of the
536 and the total detection rate increased from 49% to 83% specimens, with MAMP concentrations of 1621 and 2169
(Table 8). ␮g/L, had AMP concentrations ⬍200 ␮g/L, and 17 of the
1712 Oyler et al.: Detection Times of MAMP and AMP in Urine
specimens, with MAMP concentrations of 714-5538 ␮g/L,
contained no detectable AMP.
The initial 12-h urinary excretion profile of MAMP in
naive humans has been reported after two single oral
administrations of 30 mg/70 kg MAMP 䡠 HCl separated
by 7 days to 10 volunteers (40 ). Using a LOQ of 27.5 ␮g/L,
the authors reported that the time to the MAMP cmax was
4 – 6 h. Approximately 20% of a dose was recovered in the
urine as MAMP and 2% as AMP. AMP concentrations
plateaued by 4 – 6 h, and contrary to reports after AMP
administration (25 ), changes in urinary pH had no effect
on urinary excretion of the metabolite after this dose. In
the initial 12 h after dosing, all study participants excreted
⬃2% of the dose as AMP, leading the authors to conclude
that N-demethylation of MAMP to AMP and/or the renal
excretion of AMP were saturable processes. When speci-
mens collected up to 12 h post drug administration were
analyzed based on current SAMHSA cutoff concentra-
tions, 90% of specimens with MAMP concentrations ⱖ500
␮g/L failed to confirm because of AMP concentrations
below the SAMHSA required cutoff (200 ␮g/L). The
authors postulated that saturation of AMP excretion
mechanisms led to low early urine AMP concentrations
that were, in turn, responsible for postponing initial
detection times and reducing 12-h detection rates. Low
concentrations of MAMP were detected in some speci-
mens collected just before the second drug administra-
tion, indicating that MAMP excretion could extend to 7
days after this dose.
The urinary excretion pharmacokinetics of MAMP
have also been determined and compared after adminis-
tration of single smoked and intravenous doses to six
male volunteers who were experienced MAMP users (22 ).
For two volunteers, there was an initial lag time of 0.8 and
1.8 h for MAMP disposition in urine. Mean peak urine
concentrations occurred at 5–20 h (determined at the
midpoint of each specimen collection interval) after both
smoking and intravenous administration. Over a 72-h
collection period, 37– 45% of a dose was excreted as
MAMP and ⬃7% was excreted as AMP. Initial AMP-
MAMP ratios were ⬍5%, and there was a multiphasic
increase in the ratio of AMP to MAMP after both routes of
administration, with AMP-MAMP ratios increasing to
⬃10% by 10 h. Both analytes were still detectable at 60 h.
The authors postulated that after a single drug adminis-
tration to a single participant, a low ratio might be
indicative of recent MAMP exposure. However, they
recognized that this relationship might not stand for
multiple-administration regimens given to a population.
These data were also compared with previous urine data
collected after controlled subchronic oral MAMP admin-
istration. Single doses of oral MAMP-d3 were adminis-
tered to eight human volunteers before and after 13
consecutive daily oral administrations of 0.125 or 0.25
mg/kg sustained-release MAMP (23 ). Specimens were
collected after both MAMP-d3 doses, and data were
compared to determine the effect of subchronic MAMP
administration on MAMP pharmacokinetics. Urinary ex-
cretion kinetics did not appear to change after subchronic
dosing. Excretion rates for MAMP (in mg/h) were highest
3– 6 h after administration, consistent with the time to
peak plasma concentrations. Urinary MAMP concentra-
tions peaked in the first 3 h and remained increased
through 12–24 h. AMP-d3 excretion rates were greatest
6 –24 h after administration, and urine concentrations
peaked during the same time period. All specimens
collected ⬍72 h after drug administration were positive
for MAMP-d3 and AMP-d3 at concentrations above the
assay LOQ (2.3 ␮g/L). The percentage of the dose ex-
creted as parent drug was 56 – 66% greater for the low
dose compared with the high dose. Analysis of covariance
showed that renal clearance of MAMP-d3 was dependent
on urine pH, renal flow, and dose. In both studies, the
fraction of bioavailable MAMP excreted in urine de-
creased with increasing dose.
In the present study, comparison of peak concentra-
tions, total MAMP and AMP excreted, and detection
times demonstrated that there was no significant intra- or
intersubject dose– urine concentration relationship. Addi-
tionally, although there was a trend toward higher
MAMP urine concentrations after multiple drug admin-
istrations, no administration regimen– concentration rela-
tionship could be demonstrated for MAMP or AMP.
MAMP reached peak or near-peak concentrations in the
first or second void, but peak concentrations of AMP
generally occurred later. Consequently, low AMP concen-
trations were the main cause of low 12-h detection rates.
AMP-MAMP ratios were also initially low, but slowly
increased over time. In approximately one-half of the
dosing sessions, AMP concentrations exceeded MAMP
concentrations in specimens collected late in the excretion
phase. For every participant, AMP-MAMP ratios did
increase over time, supporting the proposal of Cook et al.
(22 ) that low AMP-MAMP ratios may be indicative of
recent MAMP exposure after controlled single doses.
However, in the present study, high intra- and intersub-
ject variability in initial and final AMP-MAMP ratios
precluded use of a single AMP-MAMP ratio as a measure
of chronologic exposure across a population or even
within an individual, as also suggested by Cook et al.
These data also demonstrate that parent drug-metabolite
kinetics become more complicated when a drug is read-
ministered before the total elimination of parent and
metabolites, as was the case after both consecutive and
nonconsecutive drug administrations. Given the variabil-
ity in dose and administration regimen of MAMP abusers
and the different routes of drug administration, establish-
ing a correlation between analyte ratios and time of
MAMP exposure would, therefore, be difficult to make
from a single urine AMP-MAMP ratio.
Application of the current 500/200 SAMHSA cutoffs to
these urine excretion data produced a low total 12-h
detection rate (16%), similar to that reported by Valentine
et al. (40 ) after single oral administrations (10%). In both
 Clinical Chemistry 48, No. 10, 2002
studies, low 12-h detection rates were attributable almost
entirely to failure of specimens to meet the AMP require-
ment. A dramatic example from the current study are the
data from volunteer S after initial administration of the
high dose, in which four of the first seven specimens
collected (2–22 h post drug administration), with MAMP
concentrations ranging from 566 to 2422 ␮g/L, had AMP
concentrations ⬍100 ␮g/L. Additionally, across all par-
ticipants, only 49% of the specimens collected from initial
dosing to last positive specimen could be confirmed by
use of current cutoffs.
In the present study, there were relatively large de-
creases in initial detection times and increases in 12-h
detection rates when the AMP requirement was elimi-
nated. When we used the 500 ␮g/L MAMP requirement
only, MAMP was initially detected an average of four
voids or ⬃9 h earlier; 12-h detection rates also increased
from 16% to 79%. Final detection times were only mini-
mally extended when AMP requirements were elimi-
nated, but total detection rates across the collection period
increased from 49% to 75%. Across participants, the total
detection window increased, and the number of positive
specimens collected through terminal excretion also in-
creased by 53% (from 292 to 448 specimens).
Reduction of cutoffs from the current 500/200 cutoff to
the proposed 250/100 cutoff also reduced initial detection
times and improved both 12-h and total detection rates.
Mean initial detection time shifted by 1.9 voids or 4.9 h;
the mean 12-h detection rate increased by 132%, from 19%
to 44%; and 12-h total detection rate increased by 75%,
from 16% to 28%. Mean final detection time increased
from 52 to 64 h. The total number of true-positive speci-
mens from initial drug administration to last positive
specimen increased by 48%. However, improvements in
times and rates, especially early in elimination, were not
as marked compared with use of a 500 ␮g/L MAMP
requirement alone.
The earliest and most sensitive detection was noted
with a 250 ␮g/L MAMP requirement alone. Initial detec-
tion times occurred in the first to fourth voids. Detection
rates across participants were comparable to rates pro-
duced by the 2.5 ␮g/L LOQ cutoff. The mean and total
12-h detection rates improved by 379% (from 19% to 91%)
and 450% (from 16% to 88%), respectively, compared with
500/200 detection rates. The mean final detection time
increased by ⬃16 h, and the total number of specimens
positive from initial dosing to last positive specimen
increased by 84% compared with the 500/200 cutoff.
In conclusion, lowering cutoff requirements from 500/200
to 250/100 will substantially improve detection rates and
increase both initial and final detection times for deter-
mining MAMP exposure. Generally, reduction in the
MAMP requirement extended both initial and final detec-
tion times and increased detection rates. Reduction in the
AMP requirement had a more pronounced effect on
detection times and rates for specimens collected later
1713
than 12 h after initial drug administration. However,
MAMP confirmation within the first 12 h of administra-
tion will be limited whenever confirmation of AMP is
required. In this study, elimination of AMP requirements
produced dramatic improvements in initial detection
times and early detection rates. These data indicate that
use of a lower 250 ␮g/L MAMP cutoff with no AMP
requirement would substantially increase detection rates
and lengthen detection windows provided that artifactual
MAMP production and misidentification in the presence
of over-the-counter amphetamine analogs is eliminated
with adequately validated confirmation methods.
We acknowledge W. David Darwin, Dianna Lafko, Anne
Basham, and Deborah Price for assistance in conducting
this study.
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